| NPI | 1679068290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTANY GRADY General Dentist/Practice Owner 317-418-7511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX 31446) |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2018-06-26 |